Project Summary/Abstract Although health behavior change slows disease progression in adults at risk for type 2 diabetes, many participants in lifestyle intervention programs do not meet or maintain the health behavior or weight loss goals. There are strong links between the quality of romantic relationships and health. An intervention that seeks to improve health behaviors as well as relationship quality has the potential to create positive and lasting change in individuals at heightened risk for type 2 diabetes. The objective of the proposed research is to develop a couple-based lifestyle intervention for individuals with prediabetes and their partners. The specific aims of the research are: (1) To qualitatively describe partner influences on health behavior change in adults at risk for type 2 diabetes, as well as their preferences for couple-based lifestyle intervention, (2) to adapt a lifestyle intervention for individuals with prediabetes and their partners, and (3) to evaluate the intervention in a pilot trial of individuals with prediabetes and their partners. We will use semi-structured interviews to examine thematic patterns in experiences of partnered individuals who participated in individually-delivered lifestyle intervention, as well as individual variations within them (Specific Aim 1). Informed by these qualitative analyses, we next seek to develop a treatment manual with broad applicability by engaging community advisors from diverse racial/ethnic backgrounds in the treatment development process (Specific Aim 2). Finally, we will carry out a feasibility and preliminary efficacy study to examine the acceptability of the intervention as well as preliminary outcome data on changes in health behaviors, health outcomes, and relationship functioning (Specific Aim 3). Over the course of the 5-year award, the candidate will participate in meetings with her mentoring team, coursework, clinical observation, and a series of career development workshops. These training activities will provide her with expertise in (1) health research with a focus on type 2 diabetes, (2) qualitative and mixed methods, and (3) community-based participatory research; as well as (4) strengthened skills in academic writing, clinical trial design, leadership, and the responsible conduct of research. The proposed research and associated career development activities will be overseen by a multidisciplinary team of senior scientists at the University of Utah. The candidate will make use of a range of resources across the University to carry out these activities, including the Department of Psychology, University of Utah Health Sciences, and the state-of-the-art clinical research facilities and services within the NIH-funded Utah Center for Clinical and Translational Science. The proposed career development activities detailed in this application will provide the necessary skills for the candidate to transition to independent investigator focused on interdisciplinary, mixed method, couple-based translational research to improve health.